Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 05181 | Date 22/12/2021 |
| Token No | SM/21-22/1702 22/12/2021 | Serial | 002 |
| Patient Name | Mrs. BABY SHAW. | Contact No | NOT GIVEN |
| Address | TIN BAZAR | Age | 45 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||